Drug & supplement interaction

Combretum Micranthum + Hydralazine, Hydrochlorothiazide

Hydralazine, Hydrochlorothiazide brand names: Apresoline-Esidrix, Apresazide.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Hydralazine, Hydrochlorothiazide falls into 2 drug categories that Combretum Micranthum can interact with; the most serious is rated moderate. Theoretically, taking Combretum micranthum leaf with antihypertensive drugs might increase the risk of hypotension.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Combretum Micranthum and Hydralazine, Hydrochlorothiazide

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Combretum Micranthum interacts with whole categories of medication. Hydralazine, Hydrochlorothiazide falls into 2 of those categories, so it can interact with Combretum Micranthum in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Hydralazine, Hydrochlorothiazide

Hydralazine, Hydrochlorothiazide falls under ANTIHYPERTENSIVE DRUGS — the group Combretum Micranthum interacts with.

Theoretically, taking Combretum micranthum leaf with antihypertensive drugs might increase the risk of hypotension.
Clinical research suggests that Combretum micranthum leaf reduces blood pressure.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Your combination pill pairs hydralazine, which relaxes blood vessels, with hydrochlorothiazide, a water pill that lowers blood pressure. Kinkeliba (Combretum micranthum) tea has been shown in some early research to gently lower blood pressure on its own. So the concern here isn't that the herb changes how your body breaks down the medicine. Instead, it may simply add to the blood-pressure-lowering you're already getting.

If your pressure drops too far, you might feel dizzy, lightheaded, tired, or get a faster heartbeat, especially when standing up quickly. The evidence behind this is fairly limited, so it's a possible concern rather than a sure thing. An occasional cup of tea may matter less than a concentrated daily supplement. Please check with your pharmacist or doctor before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Bourqui A, Niang EAB, Graz B, et al. Hypertension treatment with Combretum micranthum or Hibiscus sabdariffa, as decoction or tablet: a randomized clinical trial. J Hum Hypertens 2020. PubMed
  2. Seck SM, Doupa D, Dia DG, et al. Clinical efficacy of African traditional medicines in hypertension: A randomized controlled trial with Combretum micranthum and Hibiscus sabdariffa. J Hum Hypertens 2017;32(1):75-81. PubMed
Moderate

DIURETIC DRUGS

2 of 2

Hydralazine, Hydrochlorothiazide also falls under DIURETIC DRUGS.

Theoretically, taking Combretum micranthum leaf with diuretic drugs might increase the risk of hyponatremia.
Combretum micranthum leaf has shown natriuretic effects in preliminary clinical research.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical concern with brewing kinkeliba tea while you take this combo pill. The hydrochlorothiazide part is a water pill that already nudges your body to flush out sodium. Early, lower quality research suggests Combretum micranthum may do the same thing (push out extra salt and water). Stacked together, that could lower your blood sodium a bit too much, which we call hyponatremia.

If your sodium drops, you might feel unusually tired, dizzy, lightheaded when standing, crampy, or just foggy and weak. This is mostly theoretical for now, so it isn't a reason to panic. Still, since you're already on a diuretic, it's worth a quick chat with your pharmacist or doctor before adding the tea regularly, especially in hot weather.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Seck SM, Doupa D, Dia DG, et al. Clinical efficacy of African traditional medicines in hypertension: A randomized controlled trial with Combretum micranthum and Hibiscus sabdariffa. J Hum Hypertens 2017;32(1):75-81. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Combretum Micranthum Also Interacts With Other Medications

Combretum Micranthum has 264 moderate known drug interactions in our database — the Hydralazine, Hydrochlorothiazide one above is among them. If you take anything else, check it against the full list below.

Moderate 264 No known interaction 2,566 (incl. Hydralazine, Hydrochlorothiazide)
Taking anything else?

Check Another of Your Medications Against Combretum Micranthum

Covers the 2,830 medications we’ve checked against Combretum Micranthum. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Hydralazine, Hydrochlorothiazide

This page covers Combretum Micranthum only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Hydralazine, Hydrochlorothiazide page lists 230 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 195 moderate · 25 minor.

From our pharmacist’s overview on the Hydralazine, Hydrochlorothiazide page

“Hydralazine with hydrochlorothiazide already pulls blood pressure down two ways, so most of the supplements on this page either push that drop further or drain more potassium and fluid than the diuretic alone would. A smaller set works against it, and a few do something stranger; calcium-rich products like dolomite can build to dangero…”

Reviewed by 2 · Jul 18, 2026

Open the Hydralazine, Hydrochlorothiazide interaction page

How much people look this up

Where Combretum Micranthum and Hydralazine, Hydrochlorothiazide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Combretum Micranthum
Steady interest

#1,431 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Hydralazine, Hydrochlorothiazide
Top 25%

#453 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Combretum Micranthum

What is Combretum Micranthum?

Combretum Micranthum
  • Digestive upset
  • Liver and gallbladder support
  • Fever
  • Weight management
  • Mild urinary or fluid retention
  • Traditional opium withdrawal aid

Combretum micranthum (kinkeliba) is a West African shrub whose leaves are brewed into a traditional tea for digestion, liver complaints, and fever. Solid human studies are lacking, so its benefits remain unproven, and people who are pregnant, breastfeeding, or have liver or kidney problems should be cautious and talk to a healthcare professional first.

Read the full Combretum Micranthum monograph & all interactions
Keep checking

Other Drugs & Combretum Micranthum

Browse every other medication we’ve checked against Combretum Micranthum — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
264Moderate
0Minor
2,565No known interaction
264 Moderate 2,565 No interaction
Moderate

264 interactions

Showing 60 of 264 moderate interactions — see all 264 on the Combretum Micranthum page.

No interaction 2,565 drugs checked — show the list

We also checked Combretum Micranthum against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,565 medications checked with no known interaction — see the full Combretum Micranthum list.

See the full Combretum Micranthum interactions page
See every supplement checked against Hydralazine, Hydrochlorothiazide, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Combretum Micranthum monograph › Uses, safety, and every drug interaction in one place Hydralazine, Hydrochlorothiazide supplement interactions › Every supplement checked against Hydralazine, Hydrochlorothiazide, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Combretum Micranthum and Hydralazine, Hydrochlorothiazide Together: Common Questions

Can you take Combretum Micranthum with Hydralazine, Hydrochlorothiazide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Combretum Micranthum and Hydralazine, Hydrochlorothiazide?
Hydralazine, Hydrochlorothiazide belongs to more than one drug category, and Combretum Micranthum interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Combretum Micranthum and Hydralazine, Hydrochlorothiazide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.